External Associate Expression of Interest Form Subject Matter Experts and Invigilation Roles All sections of this form must be completed. CVs will not be accepted alone. Primary area of focus Please select your area/s of expertise below. Further details will be sought in subsequent sections. Invigilator Subject Matter Expert - SME 1. Contact Details Family Name: Contact Address Address line 1: Address line 2: Town/ City: First Names: Title (Mr/Mrs/Ms/Dr/Other): Telephone numbers Landline: Mobile: County: Postcode: Email: Please indicate which telephone number you wish to be contacted on: Company Name (if applicable): Registered Address (if different from above): Address line 1: Address line 2: Town/City: County: Postcode: Website address: External Associate Expression of Interest Form SME and Invigilation Roles (v2.1) Page 1 of 4 2. Nationality Present nationality: Do you have permission to remain and take up employment in the UK: Do you have 5 or more years’ current UK Residency? Yes Yes No No If No, please provide more information: 3. Eligibility Checklist Are you related to a Board member or member of staff at the College of Policing? If Yes, please complete the following details: Yes No Name: Relationship: If accepted as a College Associate the College expect you to undertake security clearance. Are you willing to undergo this security check? Yes No The College acknowledge you may have other business interests. Please indicate if these are likely to be incompatible with the College or bring the College into disrepute. If yes, please provide details: Yes No The College of Policing needs to operate to the highest levels of integrity to ensure its reputation and to maintain public confidence. Please give details of any spent or unspent criminal convictions or other punishments that would show up during a criminal records check. Please give details of any disciplinary offences or proceedings within the last 18 months. Note: it is incumbent on Associates to notify the College of Policing if they become subject to any criminal convictions since the submission of this Expression of Interest and once accepted onto the College of Policing ‘Approved Associate Database’. External Associate Expression of Interest Form SME and Invigilation Roles (v2.1) Page 2 of 4 4. Supporting Information Please use this section to provide evidence of your specific knowledge and skills relevant to the role you are expressing an interest in undertaking. (Please continue on a separate sheet if necessary) 5. References As part of the selection process we will require two satisfactory references. Please give the names and addresses of two referees. At least one of your references must be from a recent (last 2 years) client/employer. Please do not use relatives as referees. 1. Name: 2. Name: Address: Address: Postcode: Postcode: Email: Email: Telephone number: Telephone number: Please tick if reference can be taken up prior to interview: Please tick if reference can be taken up prior to interview: How long, and in what capacity have you known this person: How long, and in what capacity have you known this person: External Associate Expression of Interest Form SME and Invigilation Roles (v2.1) Page 3 of 4 6. Declaration The College of Policing, as the professional body for policing, has a clear role in setting standards to earn public trust. It is essential therefore that those Associates working with the College of Policing developing and/or delivering any of its products or services also meet these standards and maintain the professional reputation of the College. In order to acknowledge the importance of these considerations you are asked to read and sign the declaration below: I confirm that I will proactively inform the College of Policing of any conflicts of interest, or potential issues surrounding (including changes to) my personal circumstances or professional conduct that may potentially call into question my suitability to operate as an Associate or which may affect the reputation, or public confidence, in the product, the College or the Police Service. This includes, but is not limited to, instances of current or previous disciplinary proceedings and/or investigations, criminal convictions, HMRC compliance, immigration status or suspensions. Note 1 Declaration - It is not possible to provide an exhaustive list of what situations might apply in this context as every situation will have different circumstances therefore it will be for the individual making the declaration to consider the potential impact of the issue in determining whether to declare this. Please inform the relevant Business Unit immediately if you become aware of a situation which may compromise the terms of this declaration. If it is discovered that you have included any information you know to be false, or if you withhold any relevant information, this form may be rejected or any subsequent engagement with us terminated. By completing this application form electronically, your signature to this document is implied and accepted. Note 2 Data Protection - The personal information collected on this and other forms used during the selection and assessment process will be used for the purposes of assessing your suitability to be included as a College associate. If selected, it will form part of your associate record. The information will not be used for any other purpose and will not be disclosed to any third party. Records will be retained in accordance with College policy on retention of information. Please confirm by signing below that you give consent for your information to be used in connection with the purposes of this process and your understanding that the College of Policing will create computer and paper records about you during the selection and assessment process. I declare that the information I have given is, to the best of my knowledge, true and complete. Print Name Date: Signature: External Associate Expression of Interest Form SME and Invigilation Roles (v2.1) Page 4 of 4